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  1. Article ; Online: Investigation of the Relationship Between Frequency of Blast Exposure, mTBI History, and Post-traumatic Stress Symptoms.

    Lieb, David A / Raiciulescu, Sorana / DeGraba, Thomas / Sours Rhodes, Chandler

    Military medicine

    2021  Volume 187, Issue 5-6, Page(s) e702–e710

    Abstract: Introduction: Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are common conditions among military personnel that frequently co-occur. This study investigated relationships between self-reported blast exposure, mTBI history, ...

    Abstract Introduction: Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are common conditions among military personnel that frequently co-occur. This study investigated relationships between self-reported blast exposure, mTBI history, and current post-traumatic stress (PTS) symptoms in a population of active duty service members (n = 202) from the Intensive Outpatient Program at the National Intrepid Center of Excellence.
    Materials and methods: Participants were divided into four mTBI groups (0, 1, 2, and 3+) and four blast exposure groups (0-10, 11-100, 101-1,000, and 1,000+). Self-reported lifetime mTBI and blast history were obtained via the Ohio State University TBI Identification Method. PTSS severity was obtained via the PTSD Checklist-Civilian version (PCL-C). Several secondary measures of depression, anxiety, chronic mTBI symptoms, and sleep were also assessed.
    Results: The total PCL-C scores differed significantly between mTBI groups, with significant differences detected between the 0/1 mTBI groups and the 3+ mTBI groups. Similar group differences were noted across the three PCL-C subgroup scores (avoidance, re-experiencing, and hyperarousal); however, when comparing the proportion of group participants meeting DSM-IV criteria for each symptom cluster, significant differences between mTBI groups were only noted for avoidance (P = .002). No group differences were noted in PTS symptom severity or distribution between blast groups.
    Conclusions: This study demonstrates an association between lifetime mTBI history and PTS symptom severity and distribution but failed to identify the significant group in self-reported symptoms between the blast exposure groups. Results suggest that additional research is needed to understand the neurobiological mechanism behind these associations and the need for the development of precise assessment tools that are able to more accurately quantify significant lifetime sub-concussive and blast exposures experienced by service members in training and combat operations.
    MeSH term(s) Blast Injuries/complications ; Blast Injuries/epidemiology ; Brain Concussion/complications ; Explosions ; Humans ; Military Personnel ; Stress Disorders, Post-Traumatic/complications ; Stress Disorders, Post-Traumatic/etiology
    Language English
    Publishing date 2021-06-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 391061-1
    ISSN 1930-613X ; 0026-4075
    ISSN (online) 1930-613X
    ISSN 0026-4075
    DOI 10.1093/milmed/usab205
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Association between Sleep Disturbances at Subacute Stage of Mild Traumatic Brain Injury and Long-Term Outcomes.

    Tang, Shiyu / Sours Rhodes, Chandler / Jiang, Li / Chen, Hegang / Roys, Steven / Badjatia, Neeraj / Raghavan, Prashant / Zhuo, Jiachen / Gullapalli, Rao P

    Neurotrauma reports

    2022  Volume 3, Issue 1, Page(s) 276–285

    Abstract: Mild (mTBI) traumatic brain injury (TBI) accounts for the majority of all TBI cases. Evidence has suggested that patients with mTBI can suffer from long-lasting cognitive deficits, persistent symptoms, and decreased quality of life. Sleep disorders are ... ...

    Abstract Mild (mTBI) traumatic brain injury (TBI) accounts for the majority of all TBI cases. Evidence has suggested that patients with mTBI can suffer from long-lasting cognitive deficits, persistent symptoms, and decreased quality of life. Sleep disorders are commonly observed after TBI, with the prevalence rate of sleep disturbances in persons with TBI being much higher than that in the general population. Poor sleep quality can impair cognitive functions in the general population. This effect of sleep disturbances may impede the recovery processes in the population with TBI. The objective of this study is to add to our understanding of the relationship between self-reported sleep problems and other post-concussion symptoms and look at the association between early sleep problems and long-term outcomes in mTBI. Post-concussion symptoms, neurocognitive functions, level of global outcomes, and rating of satisfaction of life were assessed in 64 patients with mTBI. The results revealed that the presence of sleep disturbances co-occur with an increased level of overall post-concussion symptoms at the subacute stage of mTBI, particularly with symptoms including poor concentration, memory problems, and irritability. In addition, sleep disturbance at the subacute stage is associated with persistent poor concentration and memory problems, as well as worse neurocognitive function, slower overall recovery, and lower satisfactory of life at the long term. Our findings suggest that sleep disturbance can be a prognostic factor of long-term outcomes after mTBI. Early interventions to improve sleep quality can have potential benefits to facilitate the recovery process from mTBI.
    Language English
    Publishing date 2022-07-15
    Publishing country United States
    Document type Journal Article
    ISSN 2689-288X
    ISSN (online) 2689-288X
    DOI 10.1089/neur.2022.0004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: An examination of volumetric and cortical thickness correlates of posttraumatic nightmares in male active duty service members.

    Paxton Willing, Maegan M / Srikanchana, Rujirutana / Pickett, Treven C / Ollinger, John M / Riggs, David S / Werner, J Kent / Sours Rhodes, Chandler

    Psychiatry research. Neuroimaging

    2022  Volume 327, Page(s) 111546

    Abstract: Posttraumatic nightmares commonly occur after a traumatic experience. Despite significant deleterious effects on well-being and their role in posttraumatic stress disorder, posttraumatic nightmares remain understudied. The neuroanatomical structures of ... ...

    Abstract Posttraumatic nightmares commonly occur after a traumatic experience. Despite significant deleterious effects on well-being and their role in posttraumatic stress disorder, posttraumatic nightmares remain understudied. The neuroanatomical structures of the amygdala, medial prefrontal cortex, hippocampus, and anterior cingulate cortex constitute the AMPHAC model (Levin and Nielsen, 2007), which is implicated in the neurophysiology of disturbing dreams of which posttraumatic nightmares is a part. However, this model has not been investigated using neuroimaging data. The present study sought to determine whether there are structural differences in the AMPHAC regions in relation to the occurrence of posttraumatic nightmares. Data were obtained from treatment-seeking male active duty service members (N = 351). Posttraumatic nightmares were not significantly related to gray matter volume, cortical surface area, or cortical thickness of any the AMPHAC regions when controlling for age and history of mild traumatic brain injury. Although the present analyses do not support an association between structural measures of AMPHAC regions and posttraumatic nightmares, we suggest that functional differences within and/or between these brain regions may be related to the occurrence of posttraumatic nightmares because functional and structural associations are distinct. Future research should examine whether functional differences may be associated with posttraumatic nightmares.
    MeSH term(s) Male ; Humans ; Dreams ; Veterans ; Stress Disorders, Post-Traumatic/diagnostic imaging ; Stress Disorders, Post-Traumatic/etiology
    Language English
    Publishing date 2022-09-30
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 445361-x
    ISSN 1872-7506 ; 1872-7123 ; 0925-4927 ; 0165-1781
    ISSN (online) 1872-7506 ; 1872-7123
    ISSN 0925-4927 ; 0165-1781
    DOI 10.1016/j.pscychresns.2022.111546
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Development of the Blast Ordnance and Occupational Exposure Measure for Self-Reported Lifetime Blast Exposures.

    Sours Rhodes, Chandler / Sandlain, Rebecca / Ollinger, John / Bryden, Daniel / Dittmer, Travis / DeGraba, Thomas J / Teslovich, Theresa

    Military medicine

    2022  Volume 188, Issue 11-12, Page(s) 3336–3342

    Abstract: Introduction: To address the military gap in the standardized collection of lifetime blast exposures across clinical and research endeavors, researchers at the National Intrepid Center of Excellence (NICoE) completed a quality improvement project that ... ...

    Abstract Introduction: To address the military gap in the standardized collection of lifetime blast exposures across clinical and research endeavors, researchers at the National Intrepid Center of Excellence (NICoE) completed a quality improvement project that utilized systematic, iterative focus groups that leveraged the input from various stakeholders including subject matter experts, clinical providers, and service members (SMs) to develop a comprehensive, self-report blast exposure inventory that could be completed within 5-10 minutes. This manuscript outlines the process of the development of this inventory.
    Materials and methods: This project included three phases of focus groups that occurred at the NICoE between August 2020 and March 2021 to collect feedback and input from relevant military stakeholders. The study team utilized related assessments available in the literature, together with clinical experience with the NICoE patient population, to inform the development of an initial draft inventory. Phase 1 consisted of blast injury research subject matter experts who had extensive experience researching and providing clinical care to SMs exposed to blast. Phase 2 consisted of NICoE clinicians across numerous clinical specialties. Phase 3 included current active duty patients in the NICoE intensive outpatient program.
    Results: Following completion of the focus groups, a lifetime blast exposure inventory was developed in the form of a single page table including incoming, outgoing, training, and operational exposures and broken down by levels of weapon systems as well as breaching and explosive ordnance disposal exposures. In addition, select questions related to the first and most recent blast exposures and experience as an instructor for explosive ordnance disposal- and breaching-related training were included.
    Conclusions: Researchers at the NICoE developed a self-report blast exposure inventory through a quality improvement project that included active, ongoing participation and feedback of clinical experts and military SMs. The end result is a brief, single page inventory that can be administered within 5-10 minutes. Although additional research is needed to refine and validate the inventory, the project team believes that the tool begins to address a long-standing gap in the DoD in the standardized collection of lifetime blast exposures.
    MeSH term(s) Humans ; Self Report ; Explosions ; Blast Injuries ; Longitudinal Studies ; Military Personnel ; Occupational Exposure/adverse effects
    Language English
    Publishing date 2022-07-16
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 391061-1
    ISSN 1930-613X ; 0026-4075
    ISSN (online) 1930-613X
    ISSN 0026-4075
    DOI 10.1093/milmed/usac212
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Early Stage Longitudinal Subcortical Volumetric Changes following Mild Traumatic Brain Injury.

    Zhuo, Jiachen / Jiang, Li / Sours Rhodes, Chandler / Roys, Steven / Shanmuganathan, Karthikamanthan / Chen, Hegang / Prince, Jerry L / Badjatia, Neeraj / Gullapalli, Rao P

    Brain injury

    2021  Volume 35, Issue 6, Page(s) 725–733

    Abstract: ... ...

    Abstract Objective
    MeSH term(s) Brain ; Brain Concussion/complications ; Brain Concussion/diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Post-Concussion Syndrome ; Thalamus/diagnostic imaging
    Language English
    Publishing date 2021-04-06
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 639115-1
    ISSN 1362-301X ; 0269-9052
    ISSN (online) 1362-301X
    ISSN 0269-9052
    DOI 10.1080/02699052.2021.1906445
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Altered Metabolic Interrelationships in the Cortico-Limbic Circuitry in Military Service Members with Persistent Post-Traumatic Stress Disorder Symptoms Following Mild Traumatic Brain Injury.

    Song, Chihwa / Yeh, Ping-Hong / Ollinger, John / Sours Rhodes, Chandler / Lippa, Sara M / Riedy, Gerard / Bonavia, Grant H

    Brain connectivity

    2021  Volume 12, Issue 7, Page(s) 602–616

    Abstract: Introduction: ...

    Abstract Introduction:
    MeSH term(s) Brain/diagnostic imaging ; Brain Concussion/complications ; Brain Concussion/diagnostic imaging ; Fluorodeoxyglucose F18 ; Humans ; Military Personnel/psychology ; Retrospective Studies ; Stress Disorders, Post-Traumatic
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2021-10-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2609017-X
    ISSN 2158-0022 ; 2158-0014
    ISSN (online) 2158-0022
    ISSN 2158-0014
    DOI 10.1089/brain.2021.0036
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Alterations in motor functional connectivity in Neonatal Hypoxic Ischemic Encephalopathy.

    Jiang, Li / El-Metwally, Dina / Sours Rhodes, Chandler / Zhuo, Jiachen / Almardawi, Ranyah / Medina, Alexandre E / Wang, Li / Gullapalli, Rao P / Raghavan, Prashant

    Brain injury

    2022  Volume 36, Issue 2, Page(s) 287–294

    Abstract: Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is the result of global hypoxic-ischemic brain injury in neonates due to asphyxia during birth and is one of the most common causes of severe, long-term neurologic deficits in children. : ... ...

    Abstract Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is the result of global hypoxic-ischemic brain injury in neonates due to asphyxia during birth and is one of the most common causes of severe, long-term neurologic deficits in children.
    Results: Results demonstrate reduced intra-hemispheric resting state functional connectivity (rs-FC) between primary motor regions (upper extremity and facial motor regions) as well as reduced inter-hemispheric rs-FC in the HIE group. In addition, HIE neonates demonstrated increased rs-FC between motor regions and frontal, temporal and parietal cortices but decreased rs-FC with the cerebellum.
    Discussion: These preliminary results provide initial evidence for the disruption of functional communication with the motor network in neonates with HIE. Further studies are necessary to both validate these findings in a larger dataset as well as to determine if rs-fMRI measurements collected at birth may have the potential to serve as a prognostic marker in addition to the traditional combination of clinical measurements and conventional MRI.
    MeSH term(s) Brain ; Cerebellum ; Child ; Humans ; Hypoxia-Ischemia, Brain/diagnostic imaging ; Infant, Newborn ; Magnetic Resonance Imaging ; Motor Cortex/diagnostic imaging
    Language English
    Publishing date 2022-02-03
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639115-1
    ISSN 1362-301X ; 0269-9052
    ISSN (online) 1362-301X
    ISSN 0269-9052
    DOI 10.1080/02699052.2022.2034041
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Automatic Quantification of Enlarged Perivascular Space in Patients With Traumatic Brain Injury Using Super-Resolution of T2-Weighted Images.

    Zhuo, Jiachen / Raghavan, Prashant / Shao, Muhan / Roys, Steven / Liang, Xiao / Tchoquessi, Rosy Linda Njonkou / Rhodes, Chandler Sours / Badjatia, Neeraj / Prince, Jerry L / Gullapalli, Rao P

    Journal of neurotrauma

    2023  Volume 41, Issue 3-4, Page(s) 407–419

    Abstract: The perivascular space (PVS) is important to brain waste clearance and brain metabolic homeostasis. Enlarged PVS (ePVS) becomes visible on magnetic resonance imaging (MRI) and is best appreciated on T2-weighted (T2w) images. However, quantification of ... ...

    Abstract The perivascular space (PVS) is important to brain waste clearance and brain metabolic homeostasis. Enlarged PVS (ePVS) becomes visible on magnetic resonance imaging (MRI) and is best appreciated on T2-weighted (T2w) images. However, quantification of ePVS is challenging because standard-of-care T1-weighted (T1w) and T2w images are often obtained via two-dimensional (2D) acquisition, whereas accurate quantification of ePVS normally requires high-resolution volumetric three-dimensional (3D) T1w and T2w images. The purpose of this study was to investigate the use of a deep-learning-based super-resolution (SR) technique to improve ePVS quantification from 2D T2w images for application in patients with traumatic brain injury (TBI). We prospectively recruited 26 volunteers (age: 31 ± 12 years, 12 male/14 female) where both 2D T2w and 3D T2w images were acquired along with 3D T1w images to validate the ePVS quantification using SR T2w images. We then applied the SR method to retrospectively acquired 2D T2w images in 41 patients with chronic TBI (age: 41 ± 16 years, 32 male/9 female). ePVS volumes were automatically quantified within the whole-brain white matter and major brain lobes (temporal, parietal, frontal, occipital) in all subjects. Pittsburgh Sleep Quality Index (PSQI) scores were obtained on all patients with TBI. Compared with the silver standard (3D T2w), in the validation study, the SR T2w provided similar whole-brain white matter ePVS volume (r = 0.98,
    MeSH term(s) Humans ; Male ; Female ; Young Adult ; Adult ; Middle Aged ; Retrospective Studies ; Magnetic Resonance Imaging/methods ; Brain/diagnostic imaging ; Glymphatic System/diagnostic imaging ; Brain Injuries, Traumatic/diagnostic imaging
    Language English
    Publishing date 2023-12-19
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural
    ZDB-ID 645092-1
    ISSN 1557-9042 ; 0897-7151
    ISSN (online) 1557-9042
    ISSN 0897-7151
    DOI 10.1089/neu.2023.0082
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Brain Banks and Tissue Repositories for Blast-Related Chronic Traumatic Encephalopathy Research.

    Sours, Chandler / Hinds, Sidney R / McKee, Ann C / Perl, Daniel P / Leggieri, Michael J

    Journal of neurotrauma

    2017  Volume 34, Issue S1, Page(s) S4–S5

    MeSH term(s) Biomedical Research/methods ; Biomedical Research/trends ; Blast Injuries/diagnosis ; Blast Injuries/therapy ; Brain ; Chronic Traumatic Encephalopathy/diagnosis ; Chronic Traumatic Encephalopathy/therapy ; Congresses as Topic/trends ; Humans ; Tissue Banks/trends
    Language English
    Publishing date 2017-09-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645092-1
    ISSN 1557-9042 ; 0897-7151
    ISSN (online) 1557-9042
    ISSN 0897-7151
    DOI 10.1089/neu.2017.29014.bb
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  10. Article ; Online: Dynamic Functional Network Analysis in Mild Traumatic Brain Injury.

    Hou, Wenshuai / Sours Rhodes, Chandler / Jiang, Li / Roys, Steven / Zhuo, Jiachen / JaJa, Joseph / Gullapalli, Rao P

    Brain connectivity

    2019  Volume 9, Issue 6, Page(s) 475–487

    Abstract: Mild traumatic brain injury (mTBI) is one of the most common neurological disorders for which a subset of patients develops persistent postconcussive symptoms. Previous studies discovered abnormalities and disruptions in the brain functional networks of ... ...

    Abstract Mild traumatic brain injury (mTBI) is one of the most common neurological disorders for which a subset of patients develops persistent postconcussive symptoms. Previous studies discovered abnormalities and disruptions in the brain functional networks of mTBI patients principally using static functional connectivity measures which assume that neural communication across the brain is static during resting state conditions. In this study, we examine the differences in dynamic neural communication between mTBI and control participants through the application of a combination of dynamic functional analysis and graph theoretic algorithms. Resting state functional magnetic resonance imaging data was obtained on 47 mTBI patients at the acute stage of injury and 30 demographically matched healthy control participants. Results show unique alterations in both the static and dynamic functional connectivity at the acute stage in mTBI patients who suffer persistent symptoms (≥6 months after injury). In addition, mTBI patients with postconcussion syndrome demonstrated a unique allocation of time in various brain states compared to both control participants and mTBI patients with favorable outcomes. These findings suggest that global damage to the overall communication across the brain in the acute stage may contribute to chronic mTBI symptoms. Dynamic functional analysis is a powerful tool that provides insights into the brain states and the innovative analysis methodology utilized may hold the potential to delineate patients predisposed to poor outcomes upon early presentation following injury.
    MeSH term(s) Adult ; Brain/physiopathology ; Brain Concussion/diagnostic imaging ; Brain Concussion/physiopathology ; Brain Injuries/physiopathology ; Brain Mapping/methods ; Female ; Functional Neuroimaging/methods ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Nerve Net/physiopathology ; Neuropsychological Tests
    Language English
    Publishing date 2019-04-13
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2609017-X
    ISSN 2158-0022 ; 2158-0014
    ISSN (online) 2158-0022
    ISSN 2158-0014
    DOI 10.1089/brain.2018.0629
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